The present invention relates to telemedicine systems and in particular telemedicine systems useful for intensive care units.
Intensive care units (ICUs) are, for example, departments in a hospital dedicated to treating patients who need constant care or who are subject to life-threatening conditions. Such ICUs may include those specializing in neonatal, pediatric, psychiatric, coronary care, and/or post anesthesia care among other specialties. ICUs typically provide specialized equipment such as ventilators, dialysis equipment, defibrillators, and monitoring equipment which automatically monitor pulse, blood pressure, breathing, body temperature and the like.
ICUs often have high staffing needs, for example, requiring critical care nurses who can respond to deterioration in patient condition and physicians specializing in ICU practice who are available for immediate consultation with respect to developing problems. This high level of staffing can impose a significant burden to smaller facilities particularly overnight when other facility staffing is normally reduced.
To address this problem, ICU telemedicine has been developed allowing healthcare professionals specializing in ICU care but located at a remote command center to monitor multiple scattered ICU units via computer and communication networks. Such ICU telemedicine systems may provide video feeds as well as a transmission of clinical data from instruments in the ICU and may tap the local electronic medical record (EMR) system into which data about the patients may be entered manually. The availability of electronic medical record systems makes it possible to enhance the capability of the remote monitoring physician through the establishment of automated rules at the remote command center which receive clinical data feeds from the EMRs of different ICUs and monitor the clinical data for developing conditions of the ICU patients, for example, by comparing selected data elements against thresholds or monitoring trends in clinical data that may suggest an imminent problem.
The ability to use such telemedicine systems in ICU units is hampered by the need to install compatible software both in the ICU units and the remote command center. Such specialized ICU software can add an unnecessary expense to the local facility and may duplicate functions performed at least in part by the ICU EMR typically shared with a parent hospital and other non-ICU areas of the hospital.
An alternative approach to providing ICU telemedicine, allowing the local EMR system to communicate directly with the remote command center, is hampered by the variety of different types of EMR systems in use in different facilities and the problems attendant to communication with a common remote command center. A variety of EMR systems may present incompatible representations of clinical data encoded into the underlying database of the EMR. A consistent understanding of the data from each ICU is critical for automatic rule systems at the remote command center used to alert an attending physician to patient problems.
Special translation software may be developed to permit the remote command center to properly interpret and display information from each ICU in a consistent manner but developing this necessary translation software for multiple different ICU EMR systems is time-consuming and expensive, and may make the use of a central remote command center impractical for some smaller ICUs which would most benefit from telemedicine. Any translation software will need to be revised periodically as the underlying EMR is upgraded in any way that changes the type or formatting of the contained clinical data, adding to the expense of this approach.